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Jo Spence's auto-therapeutic survival strategies

Terry Dennett
Health (London) 2011 15: 223 originally published online 18 February 2011
DOI: 10.1177/1363459310397973
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Article

Jo Spences auto-therapeutic
survival strategies

Health
15(3) 223239
The Author(s) 2011
Reprints and permission: sagepub.
co.uk/journalsPermissions.nav
DOI: 10.1177/1363459310397973
hea.sagepub.com

Terry Dennett

Jo Spence Memorial Archive, UK

Abstract
The use of the camera as a therapeutic tool is now being increasingly applied within
clinical practice (photo-therapy) and, by the public, is being used as a form of non-clinical
therapeutic photography. The subject of the present article, the late Jo Spence, was a
pioneer and advocate of this approach and worked out a number of strategies that
might usefully be passed on to a younger generation. Jo Spences work is complex and
multi-sided. For this reason, this article expands on some of the categories discussed
in earlier publications, placing them in their historical context, as well as adding key
photographic illustrations.
Keywords
cancer, Jo Spence, mirror therapy, photo-therapy, therapeutic staging

Introduction
Studies and commentary on patient controlled psychotherapeutic and photographic documentation of illness are not common and explanations of methods used by such medical
autodidacts are even less so. In consequence work of this kind does not easily find its
way into the public domain, and the little that does is usually only available in ephemeral
publications not widely read by health practitioners. Hence any important ideas discovered by these auto-therapeutic explorers cannot enter quickly into professional practice.
In this article I use as an example of this situation the innovative experiments of my
late former partner and collaborator Jo Spence, photographer and pioneer of therapeutic
photography, who only now, long after her death, is finally being recognized in mainstream medical circles.
Jo Spence (19341992) was originally a professional portrait photographer who
became well known during the 1970s for her poignant explorations on the family and
self-image and her advocacy of photography as a medium to enable anyone to speak for
Corresponding author:
Terry Dennett, Jo Spence Memorial Archive, 152 Upper Street, London, N1 1RA,UK.
Tel: +44 020 7 354 1176.
Email: Dennett@GMX.net

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themselves. In 1982 a diagnosis of breast cancer prompted her to start using photography
as a therapeutic tool. Working largely on her own after this unexpected diagnosis, Spence
developed a number of counselling survival strategies using photography, mirrors, texts
and self-dialogue. This programme helped her to find a sense of direction without the
help of a trained therapist. The experience also gave her a more holistic understanding of
her situation and a desire to pass on these ideas to other of her cancer sisters who found
themselves in parallel difficult situations. Eighteen years after her death Spences work
(Spence, 1986, 1995) remains highly influential and the various practices she helped
formulate continue to inspire (Bell, 2002, 2006; see also Ribalta, 2005).

Auto-documentation as counter-information for the

disenfranchised
The first thing Jo Spence noticed when she was diagnosed with breast cancer was the
widespread social marginalization of some categories of sickness in our society (Spence,
1986). She recalled that when she had broken her leg a few years earlier everyone was
caring and sympathetic but now when she said she had breast cancer there was suddenly
a silence and reluctance to engage socially with the subject. Additionally, she began to
feel that some people now saw her as an object of pity the walking dead rather than
someone who needed social support in her efforts to overcome the condition. Breast
cancer it seemed was not a politically correct disease.
These attitudes alerted her to the importance of creating positive narratives as an integral part of her cancer recovery programme. Spences advocacy of auto-therapy was not
intended to replace medicine or collaborative physiotherapy. Spence always tried to
make it clear that the self-help programme she eventually developed should always be
seen as a last resort to be used only when professional help or collaborative physiotherapy with other cancer sufferers was not available, for example in the case of cancer sufferers in poor communities without affordable health care and counselling services. She
speculated later that her work would probably not have happened if she had been offered
a programme of physiotherapy by the hospital at the time of diagnosis.
It is also important to emphasize that Spence was only able to accomplish successfully her auto-didactic therapy because it had been preceded by a decade or more of work
in photography exploring self-image and the family plus involvement in community
arts teaching, and extended studies of fairy stories in light of the theories of Freud, Jung
and magical realism. All of these projects proved to be highly relevant to psychotherapeutic work. An additional context for Spences independent approach and self-reliant
philosophy was her experience as a wartime child evacuee in the 1940s and her later
involvement in the vibrant womens movement of the 1970s. Both these social and political conditions are now largely historic and beyond the personal experience of most
people growing up today.

Solo and collaborative therapy

Spence commenced her solo therapy programme in Nottingham, UK in 1982 and abandoned it in 1985 when she felt the need to return to London to take part in the growing

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feminist and alternative health movements. This decision led to the formulation of the
now well-known collaborative photo-therapy (Dennett, 2001, 2009) but she realized that
her earlier methods needed at some point to be made accessible through a publication.
However the demands of her daily naturopathic heath programme and then a diagnosis
of Leukaemia put these plans on hold and the work remained in her files largely unseen
until I acquired her archives in 1992.

The starting point Jo Spences practice of documenting her

daily life
Central to all Spences work going back to the 1970s was an interest in recording
personal everyday events, documentation and surveillance, as she called it. In her
workbook she explained,
When I first learned I had Cancer I used my camera as a third eye, almost as a separate part
of me, which was ever watchful, analytical and critical yet remaining attached to the emotional
and frightening experiences I was undergoing my camera must shoot on auto pilot at these
times I question the photographs later.
I think of photography as an act of writing one picture worth many words words that I and
other cancer people find hard to articulate during illness. (Taken from unpublished workbook
notes, Jo Spence Archive collection, 1984)

She said:
In my work on the Family I am trying to argue for an expanded version of the family album
one through which we can pass on the broader picture of our lives
I know from my own experience that the family albums which have come down to me are largely
about celebratory events. Births, weddings, party snaps and formal family groups important of
course, but life was more than a celebration for most of my family as they lived and fought
through two world wars
The only picture of the war I have is of me and my brother at a street party when it was all over.
My father spent 50 years at his various jobs but the only record I have of all his grinding hard
work is a photo taken at the Tilley lamp company outing where he then worked. He was an active
trade unionist for many of these years but no images of the strikes he took part in were recorded
Of my mothers working life I have nothing at all, so I have had to recreate a photo memory of
her in war work cloths to pass on to my own future family members
I am not blaming my parents they were unaware of the importance of documenting everyday
events so I and others are left the poorer for it but I hope you the viewers of my work will take
this lesson to heart and expand the subject matter of your own albums not only the happy
times but also the sad not only your internal family affairs but also a record of the wider society
that effects the family. (Jo Spence, Introduction to beyond the family album workshop. Held in
conjunction with the exhibition Beyond the Family Album Cock Pit Gallery, London, 1979)

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In her later book, Putting Myself in the Picture (1986) she discussed this in more
detail, urging her readers to pay attention to the everyday and put private life work into
the public domain, both as an act of social liberation, and a step towards giving previously ignored and forbidden personal subjects like illness a public face. This call inspired
many, especially in the disability rights movement, to show their wounds and engage in
life writing about their situations so their experiences could then be available as a gift to
future unseen and unknown people with similar problems. Spences book also urged
people to rework the traditional family album so it would be more reflective of real of
life, the good and the bad.

A review of Jo Spences basic psychotherapeutic methods

19821985
Talking therapy
Spence freely took from Freud and Adler (Mosak, 1979) and others whom she had
recently studied at college, but did not adhere to any fixed protocol. Adlers notion of
Gemeinschaftsgefuhl, community feeling, social interest turned out to be a useful
approach to the dysfunctional condition called illness! The wider motivation of
Gemeinschaftsgefuhl made her illness project move beyond a purely personal enterprise
and develop into a model she was eventually able to share with others. No doubt many
people have suffered and successfully struggled against illness but history knows nothing about them; it is as if they never lived because they did not start out with the aim of
sharing their experiences.
Jo Spence saw this talking phase as a means to an end, a necessary period of reflection, to enable her to break out of the patterned and circular thinking that had occurred
during and after her stay in hospital. Spence asked, How can I live with my damaged
body? Will I now be seen as abnormal with a mutilated breast? Will I get better?
Will I die? These questions needed to be answered with words, not photographs, at this
stage so she initiated a series of self-dialogues and daily interrogations using a tape
recorder as a silent witness. In a Note on normal pinned up on her wall, she put a
quotation from R.D. Laing (1970 [1967]: 2324 ): What we call normal is a product of
repression, denial, splitting projection, introjections and other forms of destructive action
on experiences. Her self-dialogues were also partly inspired by a pamphlet on selfhealing by Louise Hay (1976; see also Hay, 1984; and the recent DVD You Can Heal
Your Life The Movie).
Spence also augmented her dialogues with a creative stream of consciousness writing based upon the ideas of the Russian formalist Viktor Shklovsky (18931984) and
William James (1892, 1910). Shklovsky developed the method of ostranenie, or defamiliarization. This method was used in poetry and later redeveloped by Berthold Brecht
for use in his theatre as Verfremdungseffekt: making strange (John Willett in conversation
with Jo Spence, unpublished.) Jamess idea of stream of consciousness gives a more
expansive overview of a subject through the random intermingling of an unbroken flow
of thoughts, feelings and associations.

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Photo meditation
Spence was introduced to the idea of using photos as an aid to meditation and stress
control by a fellow cancer patient who was exploring visualization and meditation as
part of a treatment protocol based upon the directed daydream method of mental imaging of Robert Desoille (1961, 1965; see also Honeycutt, 2008). The directed daydream
system of Desoille therapeutically explored the boundaries between wakefulness and
sleep. His work was partly influenced by Pierre Janet, Sigmund Freud, Carl Jung, and
later influenced the methods of Roberto Assagioli (1965). Spence attended a number of
workshops on these methods and on Assagiolis psychosynthesis (Spence, personal
communication).
At the insistence of this same, now unknown, person she also experimented with
chanting and attempted the recently popularized Mongolian overtone singing then
being explored by some music therapists (Hamel, 1978). Spences first move back to
the camera after her self- dialogues involved making a series of illness diaries in
cheap A3 scrapbooks each containing a mixture of annotated photographs and text.
She found that making an auto/biographical document like this was an important part
of her therapy.
After working on a few of these diaries and studying the ideas of Dr Lucia
Capacchione (1976) she felt the need to explore journal making on a more systematic
basis and decided to enrol

in Simona Parkers creative journal workshop, a programme based upon Dr Ira Progoffs (1973, 1975) pioneering Intensive Journal
method. (Simona Parker was one of the few exponents in London intensively teaching
Progoffs work. She operated from her home in Chiswick, London for a number of
years. The Jo Spence Archive still holds a copy of the printed workbook guide she
issued to her students.)

Scripting
Scripting is a semi-ritualistic method for quickly organizing the structure of a therapeutic photo-drama. It uses a pre-formatted sequential script. This solves the problem of how
to start a therapeutic exploration when still partly disorientated by the stress of illness.
Scripts can be constructed to suit any situation and the scripter is free to use material
from any discipline or culture. Spence was particularly impressed with the writings of
Kenneth Burke (1966), whose work deals with motive. His important Pentad system
asks five questions of any discourse to determine the motive of the participants; similar
to the time-honored six news reporters questions Who, what, when, where, why, and
how from which it seems to be derived:
Act: What happened? What is the action? What is going on?
Scene: Where is the act happening? What is the background situation?
Agent: Who is involved in the action? What are their roles?
Agency: How do the agents act? By what means do they act?
Purpose: Why do the agents act? What do they want?

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Figure 1. Dialectical script

Spences first scripts were based upon this work (Allister, 1983). She later used ideas from
Russian film to create what she called a dialectical script that combined Eisensteins
(1970) Collision Principle with Pudovkins (1933) Linkage method. She also attempted
some experiments that used opposing Wounded and Warrior archetypes. See Figure 1.

Additional graphical methods

In the files there is also evidence that Spence experimented with mind mapping, a technique devised and registered by Tony Buzan (1974). Creating a visual display of nodes
and their connections, it has been used continually since then by millions around the
world in education, science and business. See Figure 2.

Therapeutic staging: work in and around photography

Spence started her photo therapeutic experiments by reworking the technique of photo
theatre she had used in the project Remodelling Photo History (1982), transforming it
from socially engaged political photography to a more personal therapeutic imagery. She
combined photo theatre with ideas taught to her by the Art and Drama teacher Keith
Kennedy (Kennedy, personal communication, 2005) who pioneered the use of the

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Figure 2. Jo Spence explaining mind map diagram

camera in therapy at the Henderson Psychiatric Hospital in the early 1970s. Spences
work at this time was also influenced by the early performance-orientated photography of
Fredrick Holland Day (18641933) (see Crump, 1995) and the early staged collaborative
work carried out by Canadian photographers Carol Conte and Carl Beverage (see http://
www.web.net/~condebev/wi_set_info.html).
Part of Jo Spences approach was also influenced by the work of the psychotherapist
Jacob Moreno (1974, 1975; Moreno and Moreno, 1969), the notion of Dialectics
(Leacock, 1972) and the ideas of the radical theatre directors Berthold Brecht, Augusto
Boal (1979, 1995 [1974]; see also Boal 1978) and Dario Fo (1991). Brecht (18981956)
was also one of Spences long-term influences. She adopted his collective and collaborative working methods and tried to apply his concepts of the Verfremdungseffekt (making
strange) and the epic theatre principle to her photography. The discovery of Boals book
on political theatre, Theatre of the Oppressed (1979), was a seminal event for Spence and
introduced her to a number of ideas she would apply to her photography. After her death
Boal published The Rainbow of Desire (1995), a discussion of his own reworking of his
political ideas for therapeutic use. So far as I know Boal had never heard of the work of
Jo Spence but like her was probably just logically reworking his ideas on radical theatre
to create a more performative approach to group therapy.

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In the late 1970s Spence heard about the work of the Italian playwright and director
Dario Fo (Behan, 2000) from one of her colleagues at the British Film Institute where she
then worked. His methods impressed her and he quickly joined her list of heroes along with
Brecht and Boal. Her use of the monologue in therapy clearly owes a lot to Fos ideas.1
Using Brecht and Boal as her early guides she decided to use the notion of audience
actor interaction to become both herself and her audience. For this purpose she created a
pretend therapist character to dialogue with, periodically halting her monologues with
herself to put on a nurses play uniform and a wig to transform into the therapist character. In this way, although she was working alone she could still be herself (the subject)
and other (the role play pretend therapist). These interactions were staged in a mirror.
After a while she also set up a camera beside the mirror to record some of the work. This
new camera-based recording became part documentary snapshots and part therapeutic
staging so she could connect what she saw in the mirror with how she felt emotionally.
She thus juxtaposed the visible everyday and her invisible (psychic) life. In some
respects by becoming the actor/observer of her own health dramas she was also adopting
some of the characteristics of what Augusto Boal called the SpectActor:
In the 1960s Boal developed a process whereby audience members could stop a performance
and suggest different actions for the character experiencing oppression, and the actor playing
that character would then carry out the audience suggestions. But in a now legendary
development, a woman in the audience once was so outraged the actor could not understand her
suggestion that she came onto the stage and showed what she meant. For Boal this was the birth
of the spect-actor (not spectator) and his theatre was transformed. (See http://www.ptoweb.org/
boal.html)

Looking at the work after all these years I can now see this was yet another of the evolutionary stages towards what would become a fully rounded therapeutic photography/
photo-therapy.

The mirror as a therapeutic tool

The use of the mirror as a therapeutic device was probably one of Spences most useful discoveries. It was particularly important to her at the beginning of her illness
journey when she found herself almost alone after cancer diagnosis. This sudden illness and a lack of funds combined to force Spence to utilize all the resources in her
immediate environment and led to the discovery that the mirror she looked in every
day with its photographic like properties could also serve as a temporary substitute for
the camera and expensive film. The mirror became her no cost way of rehearsing
therapeutic scenarios. (See Appendix 2 for her commentary on the mirror as a therapeutic tool.) See Figure 3.
It seems that Spences thesis studies of the Cinderella story provided early ideas for
the use of the mirror; she mentioned in particular the magic looking glass used by Snow
Whites evil stepmother. Some of her later research was also done on the cultural history
of mirrors. Whatever the mix of inspirations, the simplicity and flexibility of the mirror
proved to be the perfect tool for developing a new sense of visual awareness through
what became a series of self-contemplative mirror portrait exercises. Her initial approach

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Figure 3. Mirror therapy system, Jo Spence, Nottingham, 1983

using this method was to start without makeup and then gradually stage scenarios using
props to give dramatic psychical form to her inner thoughts through photo-play.
Additionally she was intrigued to read that prolonged staring at a mirror image could also
have a semi-meditative function along the lines of the so called Ganzfield Effect where
staring blankly at a featureless landscape produces a meditative effect (Metzger, 1930).

Physical therapy using a mirror

Actors routinely practise various facial expressions in a mirror as part of actor training.
Following this idea Spence decided to spend time every morning practising expressions
to gain control over various face muscles and get to know how each expression felt.
The theory was that if you can control an expression you can start to change it
consciously crying can be turned into a smile and so on. This work contains elements
of Brechts Gestic Acting style that readers may want to expand on.2

Therapeutic staging and the intruder system

Another method borrowed from the early photo theatre work was a Brechtian estrangement method Spence and I called the intruder system which facilitated some of Spences

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deliberately edgy photographs so these manipulated images were no longer designed for
our enjoyment. An intruder is something that should not be in the picture something to
stop the normalized reading of the image thus forcing the viewer to rethink the form and
content of the picture if the intruder is carefully chosen it can result in a memorable
image of great iconic power. (Note that the picture editor Wilson Hicks (1952) independently discovered intrusion effects and also noted that new concepts can emerge from the
juxtaposition of two unrelated images, which he called the Principle of the Third Effect.)
See Figures 4 and 5.
The photograph Framing my breast for posterity was made the night before Spence
went into hospital for her operation. For her this picture became a key transitional image,
the first to show a conscious therapeutic intent that was not part of the earlier photo theatre work and the beginning of her work on the nude body in illness. Spence was never
apologetic about this, and in an Introductory text written for her photo-exhibition The
Picture of Health (1985) she said:
In displaying this work (as I displayed my body previously for each of the medical, the familial
media and male gazes) I am aware that some of these images can shock. Breaking out is not a
painless process for anybody. In cracking the mirror for myself I cannot but challenge your
view too. By giving expression here to my life I will stand in contradiction to those who have
the power to repress or deny the experience of others so be it.

The sequence of methods described above evolved quite organically as part of the
ongoing process of confronting illness. She never had time to put this all together into a

Figure 4. The body is the hero Jo Spence/Terry Dennett, 1983

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Figure 5. Showing my wounds, Jo Spence/Terry Dennett, 1982

workable system for the therapeutic community. Spences work has inspired many students world-wide but so far I have had few reports of it being used in mainstream
practice.

Society as a spectacle: illness as a spectacle

Spence often mentioned in her lectures her debt to the work of the The Situationist
International (Knabb, 1981) and to one particular book, The Society of the Spectacle
(Debord, 2000 [1967]). This was written by one of its founders Guy Debord (19311994)
in which he explained the prescient notion that everything that had once more or less
been directly lived in society was now in the contemporary world transmuted into nothing more than a representation, an idea. Debord gained from studying the work of the
philosopher Feuerbach (18041872):
But certainly for the present age, which prefers the sign to the thing signified, the copy to the
original, representation to reality, the appearance to the essence ... illusion only is sacred, truth
profane. Nay, sacredness is held to be enhanced in proportion as truth decreases and illusion
increases, so that the highest degree of illusion comes to be the highest degree of sacredness.
(Feuerbach, Preface to The Essence of Christianity, 1843, quoted in Debord, 2000: 6)

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Noting this, Spence realized that she had indeed been living a lot of her life indirectly,
often at times fooled by slick advertising and government PR departments ever eager to
give the citizen appearance rather than essence. These thoughts and a growing feeling of
alienation led her to re-evaluate critically the medical system she had to enter after her
diagnosis of breast cancer. It was a system which seemed to be resistant to her simple
demand to be treated like an autonomous human and be actively involved in her health
care rather than be medicalized and processed into an anonymous outsider. One is
reminded of a quotation from the writer Colin Wilson (1996 [1957]: 9):
the Outsider is a symptom of a civilizations decline; Outsiders appear like pimples on a dying
civilization. An individual tends to be what his environment makes him. If a civilization is
spiritually sick, the individual suffers from the same sickness. If he is healthy enough to put up
a fight, he becomes an Outsider.

We might also say that Spence as a non-productive person also now occupied what the
anthologist Arnold van Gennep (1960) in his work Rites de Passage described as a liminal
or in-between state, a being-in-transition, still in the world but no longer fully with it.
The growing gap between her ideas and those of the hospital were highlighted one
week after her diagnosis when in preliminary discussions with hospital staff she was horrified to find that the importance of immediate cancer counselling in her local NHS
hospital was not fully appreciated or adequately funded. Additionally she discovered that
cutbacks in regional hospital services meant that systematic training programmes for
specialized cancer counsellors were absent in many areas.
The general recommendation of the time therefore was to give a patient antidepressant
drugs and send them on their way to await hospital admission. Additionally the cancer
treatments suggested were restricted to three basic modalities: surgery dominated by the
mastectomy rather than the lumpectomy she wanted; the far from precise radiation exposure; and the use of toxic chemotherapy drugs sensitive to imprecise dosage which she
refused. In the intervening years she has been vindicated as many of these drugs have been
prudently and quietly withdrawn. The part played by lifestyle and diet in assisting in
recovery was not then acknowledged. A hospital lunch would often be nutritionally deficient fast food, in spite of the fact that many hospitals employed registered nutritionists
who should have known better. Worse still the average doctor and nurse were often heavy
smokers and hospitals still allowed staff to light up within the premises.
It was against this background that Spence decided to opt for the more traditional
gentle naturopathic methods demanded by rich patients in Swiss clinics. Not being rich
she was forced to create her own independent cancer survival programme assisted by the
newly formed Bristol Cancer Centre (now The Penny Brohn Centre) founded by Dr Alex
Forbes and his colleagues and then embark on the psychotherapeutic methods I have
discussed in this article.

Spences thoughts on the role of photography in therapy

The photograph should serve as a jumping off point to direct us to real life situations existing
outside the photographic frame. Our Photographs should present the viewer with questions, the

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work we do will only have a final reality effect when it functions as an arena for discussion and
more importantly acts as a call to action.
Photography transforms a living scene into a piece of two dimensional graphic art a
representation of the moment but drained of all life, sound and smell an abstraction, a fragment
of the moment but unlike our ephemeral memory it can be shared. It is a physical object we can
hold it, pass round, discuss and archive for posterity. So I see Photography as a magical process.
What other method can catch and hold a memory, reach beyond our normal visual capabilities
to see close up or bring the far distance closer Capture fractions of a second unknown to the
eye or long periods of time we cannot perceive The magic does not stop there With filters and
by under or over exposure we can change the tonal structure to create visual drama that did
not exist in reality a fitting medium for our therapeutic endeavors. (Workbook notes,
Nottingham, 1982)

Mind and body (1983)

Illness must be treated as a Shamanistic journey not in a religious way but as a way of healing
my inner self (which is not religious) as I understand it the Shaman takes on the cares of the
world and seeks to heal by personal mortification.
So I must perhaps stand in place of my other cancer sisters not yet aware that they can do things
for themselves I need to demonstrate alternative practice, the importance of healing the outside
by first healing the inside.
Sadly I now find there is not yet a place in the tool box of the cancer industry for connecting
mind and body, only barely connected separate disciplines for mind and body. So it seems to
me re-connecting my mind with my body, getting rid of the mechanistic notion of the Mind/
Body split is an urgent task.
Perhaps I must become a child again, go back to that time in my life when I saw no distinction
between mind and body no difference between my perceived reality and mental fantasies
when fairy stories were as real my everyday experience important to explore magical realism
method here in connection with photography. (Notes to myself retrieved from a disc after Jo
Spences death)

Jo Spence: an afterward and a warning

Jo Spence survived her breast cancer against all the odds, with very little money, either
for commercially made medicines, or the crucial biochemical tests she sought as an
objective means of monitoring the process of her preferred treatment system. Her
research likewise had to be carried out without official access to important medical collections and her requests for specific bits of information from doctors and specialists
were often grudgingly given, and then usually only against a background of psychologically damaging criticism. She was told: You will die within 12 months the time varied
according to the doctor if you dont have radiotherapy/chemotherapy/surgery. The
treatment varied according to the preference of the specialist. These predictions grew

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less credible as the patients of these specialists (the recipients of the very best radiation,
chemicals and surgery that money could buy) began to die.
This was not in the script how could this woman living on carrot juice, vitamin C
and strange potions not only survive but look at the very peak of health? Spences successes with her treatment lead her to accept an offer to tour with her photographs for
three months throughout Australia, the USA and Canada, during the course of which she
had to give up her health treatments. Returning home at the end of the trip she complained of excessive tiredness and was diagnosed as having leukaemia. She attempted to
restart her health treatments again to meet this new challenge but her exhausted body was
no longer responding as it should. She died within a year.
Appendix 1: Bertold Brecht: dramatic and epic theatre
Dramatic Theatre

Epic Theatre

plot
implicates the spectator in a situation
wears down the capacity for action
provides spectator with sensations
experience
the spectator is involved in something
suggestion
instinctive feelings are preserved
the spectator is in the thick of things
the human being is taken for granted
humans do not change
eyes on the finish
one scene gives way to another
growth
linear development
evolutionary determinism
human being as a fixed point
thought determines being
feeling

narrative
turns the spectator into an observer
arouses the capacity for action
provokes the spectator to make decisions
picture of the world
spectator is made to face something
argument
brought to the point of recognition
the spectator stands outside and studies
the human being is the object of inquiry
humans can and do change
eyes on the process
each scene for itself
montage
curves
jumps
human being as a process
social being determines thought
reason

Source: Bertolt Brecht (1930), The Modern Theatre is the Epic Theatre originally composed as a set of
notes to accompany his opera Rise and Fall of the City of Mahagonny.
Note: Ideas from this Epic theatre Chart was used by Spence as the basis for her first therapeutic staging
in 1982. (see Fig 5) Later with a colleague, Rosy Martin, she modified Brechts epic theatre concept for use
in what became known as Collaborative Photo Therapy (see Spence Putting Myself in the Picture (1986) ,
chart on pages 184-185).

Appendix 2: Mirror practice notes self-portraiture therapy (1984)

Desensitisation release emotions change tight body language re model old image
into something else say Yes when my face and body says No To look when my mind
says dont look at that mutilated Breast
To change the visual concept from dependant self pitying victim to a positive a survivor Cancer War Hero put on some medals a soldiers hat??? People used to look
up to War heroes didnt they not any more though!!!!!!

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Qualities to think about

The Mirror is dumb non evaluative and non human whatever I do in front of it It cant
be critical like a person It is not my Mummy or Daddy mirror pictures are a private
self activated show just for me until I want to invite others in.
Mirror images cannot be saved for others to see later so it is safe to be uninhibited
and show/release my most exposed self ? Important when Im vulnerable to work
alone for a session??? But needs courage do/will I always have the courage to face
reality alone??
Mirror image is a reflection of the living image in real time but as ephemeral as real
time it is not automatically preserved except imperfectly in memory
The Photographer as a Resurrectionist not a body snatcher not TAKING pictures but
reconstituting events
The Camera process can encapsulation real-time aspects but only as a dead embalmed
cultural artefact photographs are pieces of paper why do people forget that So our
task as photographers is to resurrect these dead things to use our Art to get the shapes
encoded in the paper to express something of the realities of the former living essence we
confronted with our camera
Thank God for a shared process of communication What would we do without it and
who will truly read our images and our intent when we do not share the same cultural
codes?
Mirror image a part self a shadow self looks real moves in time and space but only
a reflected illusion therefore some of my pretend situations and constructed image
rehearsals will be no less real than others I can choose my visual reality dress up
makeup all appear real but all are illusion in the mirror
The Mirror and the Camera Set up Camera with bulb release to click any useful images
first start with mirror rehearsal No Photos only looking then more photos less looking. (This version recovered from a disc after her death.)
Acknowledgements
Thanks to the following for reading and commenting on drafts of this article: Sylvia Ayling
(London); Dr Einat Avrahami (Israel); Judy Weiser (PhotoTherapy Center Canada); Dr Mellissa
and Nelson Wilby (WellSpring Book Shop, London). I would also like to thank Peter Ellis books
London for help with reference research.

Notes
1 While researching references on Dario Fo for this article I came upon a remarkable quotation
from his book Tricks of the Trade (1991) also quoted in an interesting article by Wing (1993),
The iconicity of absence: Dario Fo and the radical invisible. It regards an incident worth retelling here. Fo describes a performance at a mental Institution for untreatable cases. He is
playing himself and dialoguing with an invisible antagonist whom he places in an empty spot
on the stage. A patient began reacting to his treatment of this (invisible) antagonist and threatened to come on stage and sort Fo out, an astonishing example of the power of drama. Later
he remarked to students that this patient had not spoken for years. Following this incident
other inmates in his audience who were tied to their beds in the traditional manner of the day
expressed a desire to come on stage and speak about their oppression.

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Health 15(3)

2 This was Brechts method of getting actors to demonstrating their gestus (attitude) through
the physical disposition of the body to show what is happening in the scene, a method probably
derived from the work of Meyerhold, according to the late John Willett (in conversation with
Jo Spence, see Willett, 1964).

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Author biography
Terry Dennett was the former partner and main collaborator of the late Jo Spence. For the last 18
years he has curated the Jo Spence Memorial Archive, London. In his curatorial role Dennett organizes exhibitions and workshops and assists students worldwide who are interested in Jo Spence
and her therapeutic concerns. He is also a Fellow of the Royal Anthropological Institute with a
special interest in urban crises and social exclusion, and is also President of the Association for
Historical and Fine Art Photography. He can be contacted at Dennett@GMX.net

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